In my last article I mentioned that working memory is another factor to consider when looking at anxiety in our children. Bob Doman, founder and director of NACD, has been at the forefront of understanding working memory and its impact on global function since the early ‘80s. It is a big deal. It is not just big, but huge, gargantuan, as it is the foundation that permits us to think. It not only permits us to think, but it also plays a role in our ability to regulate our emotions. Let’s spend some time on working memory, defining its role in our ability to handle stress.

Let’s first review how the brain works in a simple way. Information comes into the brain through our senses. If our sensory channels are functioning normally, the information gets perceived correctly, then it gets processed through our short-term memory. Our working memory is what allows us to think about this information along with taking information that we already know out of long-term memory. For example, if I am sitting in a class and I am listening to a lecture, I am taking in what that teacher says, hearing the information, processing what they are saying, and using my working memory to think about what I already know about that topic, how what they say impacts what I already know, what client comes to mind when I think of what the teacher is saying, etc. I am visualizing, conceptualizing, and developing an opinion or my own thoughts about that particular topic and how it may or may not benefit my work.

According to Bob Doman, “Working memory is the foundation for global neurological maturity and function. It essentially encompasses most of what we think of as ‘thinking.’”

“The NACD model of cognitive function recognizes various components of thinking and learning. Of all of these functions, working memory, including executive function, encompasses the areas that impact simple and complex behavior regulation and problem solving the most. The development of various parts of executive function appears to be a good indicator of future academic success, as well as future life success. Mathematics, reading, and critical thinking are all affected by how well various components of executive function develop and work. Not only do these neurological functions impact academics, but NACD and researchers also find that they impact social skills, job skills, and the skills needed for a child or adult to navigate daily life independently. Time management, time awareness, goal setting and planning, organizational skills, social awareness, financial planning, running a household, writing a research paper, writing a paragraph, and forming thoughts into conversation are all functions that depend on this higher cognitive level referred to as working memory and executive function.” (Doman, 2016)

So what does all this have to do with anxiety? When we think of our kids, anxiety can creep up when they have too much information coming in through their senses, but not enough short-term and working memory to manipulate the information. Have you ever seen a World History textbook? If you have a smart kid who wants to do well in school, but doesn’t have well developed short-term and working memory abilities, they are very likely to get anxious just looking at the book. The pieces that allow them to manage their time with material, organize their studying, and plan how to work through the material are not where they need to be in order for that child to be successful. Now if we have that same kid with five or six classes, with similar amounts of material, imagine how much more anxiety can develop.

Many of the anxious children on our caseload, who may be pre-adolescent age and are struggling with school to the point of shutting down, have poor working memory and conceptual thought. They simply don’t have the ability, YET, to be able to perhaps even process the information coming into their brain, let alone manipulate it and problem solve, think and reason through all that is being presented to them. Let’s also take into consideration what is happening with their bodies during this time frame. They become so overloaded they shut down. With our kids that have good short-term memory but poor working memory, rather than solve a problem that they are facing, sometimes these children may ruminate on the problem itself. Rumination is simply rehashing a problem in their head over and over without having the working memory that permits them to organize their thoughts and reach a conclusion, therefore creating increased anxiety. The more developed a person’s working memory is, the more likely they are able to solve and reason through their problems.

The more a child can reason, the less likely they are to get stressed and shut down. If we look at a neurotypical 3-4-year-old, they are just learning how to reason and problem solve. If they encounter something that is stressful to them, they don’t have the working memory to process the situation and are likely to dart or hide behind their mom versus using conceptual thought to reason as to how best to approach something. The same can be true for a child who is 12 years old but has the working memory of a 3-4-year-old. The same behavior happens, only it looks more problematic because it is an immature behavioral response for a child at that age.

We also have very bright individuals on our caseload who are also anxious because of their incessant need to be the best, to be perfect, to be the straight A student. When does academic pressure, measuring kids, too much testing, and narrow competition get recognized as potentially one of the greatest causes to mental health issues in our kids? Stay tuned to next month’s article.

Reprinted by permission of The NACD Foundation, Volume 32 No. 9, 2019 ©NACD

The post Anxiety in Our Children: The Impact of Anxiety on Working Memory appeared first on NACD International | The National Association for Child Development.

To be proactive is to anticipate, prepare, and intervene based on a long-term vision and perspective. When anticipating the future, you react accordingly before it actually happens.

To be reactive is to respond to a situation, rather than creating or controlling it.

How does this relate to what we do with our children? What we do in the short term affects the long term; and that myopic/short-sighted intervention can have a negative impact on outcomes.

One contributing cause is lack of a vision, lack of hope, and a willingness to accept a short-term possible solution. Another underlying issue is that most teachers and therapists are not involved for the long term and are not aware of the long-term results or consequences of their interventions. The third contributing factor is a lack of awareness and knowledge of the whole child. When looking only at pieces, one cannot perceive, acknowledge, utilize, or evaluate the impact on the gestalt of the individual.

Armed with decades of experience working with tens of thousands of “Whole Children”, it is relatively easy for us at NACD to look at your children and to be proactive. Being proactive requires looking at a child’s strengths and talents. In addition we must look at weaknesses and issues, determine what pieces we need to put together or issues we need to resolve, in what order, and in what priority to produce a good ultimate outcome. One of the benefits of working with “Whole Children,” working with the full spectrum of children, and working with individuals (often for decades) is that we have the benefit of experience and perspective.

Working with “Whole Children”

I have spoken at length about the importance of working with “Whole Children.” Working with “Whole Children” simply means we are working with all aspects of the child from their health, sleep, sensory function, social function, behavior, speech, language, fine and gross motor function, cognition, and academic development to their attitude, self image, etc. I don’t know if it is possible to be truly proactive without working with the whole child. Most children have disconnected individuals addressing various aspects of their lives, coming and going; and the more issues a child has, generally the more people there are working reactively, not proactively, with them. Working “reactively” means they are reacting to what is perceived as an immediate issue or need, without an historic or long range, long-term vision.

In discussing all of the people who can be involved with your child, you are tempted to associate them all somehow, to call them a team or an army, suggesting that they are somehow a cohesive unit working together. The reality is that they are individuals working with pieces, more often than not in virtual isolation. Such individuals are often working reactively, not proactively. They are working with their one piece generally in virtual isolation and establishing their piece as their priority and generally from a perspective that they are only going to be involved for a relatively short period of time. Working with children for only a few months, or even years, does not permit one to gain a long-term perspective and to understand the implications of what is in reality short-term, reactive intervention.

Proactive Intervention

To help clarify what it means to be proactive, it is best to look at the antonyms or words that are essentially the opposite of proactive. Those words include such things as myopic or short-sighted or improvident. Another way to look at this is to say we are being reactive as opposed to proactive.

Reactive Intervention

If we are being reactive, we are reacting to problems; if we are being proactive we are looking forward, into the future, so as to prepare for the future. As parents with limited experience, it’s often difficult to be proactive. It’s difficult to be proactive if you have not had the experience and knowledge to know the degree to which what is happening today, or not happening today, is going to influence tomorrow, next week, next year, and the future. Sadly, many therapists and educators do not work with individuals over long periods, as in decades, to understand what issues can be created by working perhaps hard, but not working from a long-term, proactive perspective.

Some common examples of being reactive rather than proactive would include things like teaching young children with Down syndrome to sign. (link to Signing contra-indicated for DS) The perception is that Johnny isn’t talking and is frustrated, so let’s give him a means of communication that he can use soon–signing. Looking at the short-term results, which may be the child being able to communicate a few basic needs and being perhaps less frustrated, reinforces the use of signing. But if looked at long-term and proactively, we discover that we have had a negative impact on the child’s ultimate ability to communicate verbally, and even more significantly, have had a negative impact on the development of the child’s auditory processing, with resulting adverse affects on the child’s cognition and global maturity. Reactive intervention is not the best intervention.

One of the more glaring areas where we often see disastrous effects of reactive intervention is in the area of mobility and walking. We sometimes have children come to us who never developed the neurodevelopmental or the structural foundation that can ultimately produce a child who is a functional walker. Being proactive, we know that we have to follow a typical sequence of development, which among other things, requires the neurological, tactile, proprioceptive, and structure pieces of the child going through the necessary developmental stages before working on standing and walking. Children in walkers who had been “helped” to stand before they had the strength and structure to do it themselves, or do it properly, and then “assisted” to walk using various apparatuses to hold them up so they could move their legs, usually end up not being able to walk independently. Often they have created structural issues that even numerous surgical interventions cannot properly address. Children you see walking with walkers or braces and crutches almost always end up in wheelchairs. Yes, the goal is walking; but can we achieve it by circumventing the foundational pieces?

An example of a reactive approach in education is encouraging children to write before they neuro-developmentally are ready. Sixty or seventy years ago, it was not uncommon to make left-handed children in kindergarten and first grade, at five or six years of age, write with their right hands. This practice was stopped because interfering with the natural development of handedness resulted in a plethora of neurological and even emotional problems. Today this isn’t happening; but today we have preschool education, which is even creating more problems by making children write before they developmentally have even firmly established a dominant hand. A child may be leaning toward the right hand, for example, at three or four, and if encouraged to write with the right hand, establish a skill set for writing with the right hand. Ultimately such a child may turn out to be left-handed. Because the skill set for this specific function was established, the child will tend to continue to write with the right hand and is generally encouraged to continue to write with the right hand, resulting in all of the issues that were created 60 years ago, including poor handwriting.

The Reality of Education

The reality of education in general is that the very structure and organization of school as we generally know it almost defines reactive intervention. Education is generally perceived from the short-term perspective of needing to get specific curriculum material into a child’s brain, whether or not the material is targeted to the specific child’s present knowledge base, to their level of processing and understanding, let alone their interests. The net result of reactive education is very often poor outcomes, children often learning to dislike or “hate” school, which becomes synonymous with hating learning; and often because of the abnormal environment of narrow competition, leaving the system with a damaged self-image and lacking a perspective of who they are and what they can be. Proactively it’s not difficult to understand that at the foundation of education we should have the goal of teaching the child to love learning and to make them feel that they are smart and can learn. Is anyone shocked to hear that children do well learning things they love and struggle with what they hate? If the goal of education is to produce adults who are actually educated, who become not just lifelong readers, but life long learners with the confidence to pursue their hopes and dreams, then the system needs to be re-evaluated and made proactive not reactive.

Educational & Therapeutic Perceptions

There are numerous examples in educational and therapeutic intervention that demonstrate the negative aspects of reactive intervention. The problem is ubiquitous, and it doesn’t seem to be changing anytime soon. Proactive intervention implores us to look at the child from a long-term perspective and with a vision and a plan to produce better outcomes. If existing outcomes are perceived as actual reflections of an individual’s potential, there is no motivation for change.

Perception of potential is a reflection of one’s experience. I recall a colleague correcting me many decades ago when I referred to someone as having twenty years of experience. He told me that the reality was that they had a year of experience twenty times, not twenty years of experience. I have been extremely disappointed to see how incredibly slow change in traditional education and therapeutic intervention has been. But doing the same reactive things year after year and producing the same limited results has not stoked change, but has reinforced the perspective of limited potential, and has encouraged many educators and therapists to keep doing the same things, producing the same inevitable outcomes.

Proactive intervention is stimulated by a need to do things better and to improve outcomes, all of which is perpetuated by a vision of what can be and what should be.

Reprinted by permission of The NACD Foundation, Volume 32 No. 5, 2019 ©NACD

The post Developmental/Therapeutic Intervention: Proactive or Reactive? appeared first on NACD International | The National Association for Child Development.

by Bob Doman

In a previous post, I talked about getting unstuck and how to help change the picture and the minds of children who have weak auditory processing and who are strong visualizers. This combination is never more of an issue than it is with children on the autism spectrum, particularly those who are becoming teens.

Before I go any further, let me say that the combination of strong visualization, addictive behaviors (DSAs), low auditory processing, strength, and hormones is a combination you really want to do you very best to prevent.

This is an issue primarily for children who are “autistic” and generally not for others that are included on the spectrum. One of the primary, if not definitive, issues that separate those on the spectrum is auditory processing. The higher the auditory processing, generally the higher the child is on the continuum. The lower the auditory processing, the more likely we are to encounter this behavior management issue.

Let’s begin by talking a bit about auditory processing, maturity, and behavior. Simplistically you can determine auditory processing, which includes auditory short-term memory, working memory, and executive function, by measuring sequential processing. The first step in auditory sequential processing is short-term memory, which is a measure of how many pieces of auditory input (words) the child can process. If I were to test your auditory sequential processing, I could simply have you listen to a sequence of numbers said slowly and repeat them. With children we can do this as well, or have them follow different kinds of sequential verbal directions.

If I were to do a simple assessment of your auditory working memory, I could again say a sequence of numbers, but this time have you repeat them backwards. To some degree this would be a measure of your complexity of thought.

Executive function is a mechanism related to working memory and complexity of thought. Executive function includes those things we would tend to attribute to people who function well, such as the ability to prioritize, problem solve, and have organizational skills and inhibition, which is essentially stopping yourself from doing things that you know you shouldn’t do or that are harmful for you.

The development of these pieces can be looked at relative to the digit spans I mentioned before.* If we look at the typical development of auditory processing correlated with digit spans or their equivalents, we have approximately the following picture (understanding that the range can easily be +/- 12 months or more):

Auditory forward sequence of 1 = 6-18 months

Auditory forward sequence of 2 = 18-30 months

Auditory forward sequence of 3 = 24-40 months

Auditory forward sequence of 4 = 3 yrs-5 yrs

Auditory forward sequence of 5 = 4 yrs +

Working memory starts kicking in when the forward processing is about a 4. Up until this point, working memory is very limited.

Disregarding various personality differences, when we look at the full range of children, we can to a certain degree associate the auditory processing and complexity of thought with level of maturity and behavior.

Babies 12 months and younger, who are just learning to understand and process language, are pretty easy to deal with as long as they feel fine, aren’t tired or hungry or need a diaper change. You can give them something and they can like it, or you can take something away and they might not particularly even miss it.

When processing starts getting into the 2s, life gets interesting; and we hit what has historically and aptly been called “terrible 2s.” At this point the complexity of thought generally permits the child to process/think “I want” or “I don’t want.” The complexity of thought provides no qualifiers; there is no “later” or “after” or “because.” At this level we should expect and get a lot of tantrums.

I have categorized 3s as “lock and block 3s.” The complexity of thought and lack of working memory doesn’t permit children to think through anything with any real complexity. They rely on familiar patterns and the perception of whether something feels good, feels safe, is non-threatening and fun, or if it breaks previous patterns, doesn’t feel good or safe, is in some way threatening, feels like work, or is important, or simply not fun. Children at this stage can be very intractable and react very poorly if pushed out of their comfort zones.

As we start moving into processing 4s and above, we start getting to a point where we can have some negotiating power and the kids start really using working memory. They can think through things or think their way out of things or old patterns.

I encourage everyone who works with child development and education, and particularly with those who work with special needs, to look at individuals through the lens of processing power and not chronological age. Just because a group of children are approximately the same age doesn’t mean that their functions are going to be very similar or that it is appropriate to be working on the same functions or skills. A typical group of 3-year olds could have auditory processing ranging from a two to a four or more and see the world as very different places. Certainly it is not appropriate to treat them all the same and have the same expectations for all of them. (Not to digress, but perhaps we should help all children development their processing skills. What a great idea! I’ve been trying to get the world to understand this for more than 40 years!)

Relating back to the behavior patterns discussed, imagine a six-foot tall, strong, hormone-driven, visualizing two or three year old. Imagine the tantrums your typical two or three year old might have thrown in the grocery store when you refused to buy them the candy they wanted. Now imagine them being this six-foot, hormone driven, thirteen plus year old child throwing that fit. Do you think that many of those typical two and three year olds physically resist and fight you? Yep! Do you think you would be in major trouble if your two year old were six feet tall and strong as an ox? Yep! Then think about throwing hormones into the mix. And now just think about adding the fact that autistic children are almost universally strong visualizers and probably have a very strong video in their heads as to what they want and don’t want and what should and shouldn’t be, and you have a very intractable child. Breaking or changing a low processing child’s mental picture when they lack the processing power to think their way out of a it can be extremely difficult and even dangerous.

For every parent of every young child on the spectrum, it is imperative that you understand that developing your child’s cognitive abilities needs to be at the top of the priority list. It saddens me (and certainly at times when a family brings me one of these low processing, out of control teenagers infuriates me) that millions and millions of hours and dollars are being spent, not addressing the fundamental sensory issues, DSAs/addictions, and processing power of these children, but teaching them isolated skills and to be prompt-dependent, using antiquated programs like ABA (Applied Behavior Analysis Therapy).

Steps can be taken, starting from when children are tiny and throughout their lives, to build and develop these basic, indispensable cognitive functions and normalize sensory issues, break addictive patterns, and develop the neurodevelopmental foundation that permits them to communicate, learn, integrate into society, and function well.

For those of you who have the low processing, hormone-driven, difficult teens, all isn’t lost; it’s just difficult, and for some very difficult. Many of you are in survival mode and need to use whatever tools are at your disposal to cope. But ultimately we must utilize all of the tools to build the processing, cognition, and maturity to move them forward.

*Assessing auditory processing with strong visualizers is a bit tricky and requires someone with experience and specific expertise. Visualizers tend to produce inflated scores that don’t necessarily reflect their true processing level.

Reprinted by permission of The NACD Foundation, Volume 31 No. 5, 2018 ©NACD

The post Autism – Stuck Teens appeared first on NACD International | The National Association for Child Development.

Over the last few years, I have really been pleased to have families that we worked with in the past reconnect and provide updates. This week I received a very special call from a family that I worked very closely with for many years—the Giroux family. All three of their children were on the NACD program. It started with Celeste. Celeste had a diagnosis of Autism when she came to me. Beverly, Celeste’s mom sends me updates from time to time on how the children are doing. Sometimes we meet for lunch and sometimes I just get a note. But, this week’s call was phenomenal! The phone rang as I was getting into my hotel room after a very long day of evaluations. I almost, just almost, didn’t answer my phone, because I did not recognize the number. The minute I heard Beverly’s familiar voice, I was so glad and instantly energized. Immediately following my hello was “I love you. I love NACD. I love Bob Doman.”  Following that, I got an outstanding update. Celeste, now a beautiful young adult, finished her GED and earned her esthetician license. Celeste is working full time at an upscale makeup counter at the Dallas Fort-Worth Airport. She is happy, productive, and has developed into a really awesome adult. She found her passion and turned it into something she now contributes to the world. I cannot express how wonderful it was to pick up that phone and hear this young lady’s successes. This is why we at NACD do what we do—we empower parents to propel their children toward their full potential.

At Celeste’s initial evaluation, she had very limited language skills. It was limited to a handful of wants and needs and a bit of echolalia. As her mother and I covered her history and I gathered information, Celeste spent much of her time sitting in the floor, flipping the hair on her My Little Pony back and forth, and back and forth again. Her level of engagement was low and she spent her time locked within her head and stimulating her broken sensory channels. Over the first year, Celeste made big improvements. By giving her sensory channels the specific input that was needed, the world that used to torment her became a world to notice, to interact with and to enjoy. By working on her processing abilities her language and complexity of thought exploded. Academically she really took off and socially, she was much more in tune and engaged. While big gains were made, there were still stages of work as Celeste progressed through the various stages of her development. I can vividly remember a bit of a tough patch when things were not so pleasant due to Celeste’s meltdowns and outbursts of emotionality. Beverly had to spend much of the day directing and redirecting Celeste to activities that were “good for her brain” rather than activities that were debilitating. We worked closely with Beverly as we built logic and executive function so that Celeste was not “held hostage” by her emotionality. A lot of pieces had to come together, but Celeste continued to develop, to improve and later to excel.

Celeste was blessed with a family that believed in her unlimited potential. I am humbled to have been a part of Celeste’s journey. We are so proud of you!

NACD Newsletter, March 2018 ©NACD

The post Celeste Giroux: Where is she now? appeared first on NACD International | The National Association for Child Development.

Understanding and remediating the neurodevelopmental issues of those within the autism spectrum is critical if we are going to provide these children and adults with an opportunity to overcome their issues and to function at higher, “normal,” or even “superior” levels. It is important to understand that most neurodevelopmental issues will not simply go away. Merely teaching new skills or applying aggressive medical or nutritional intervention without addressing the underlying neurodevelopmental issues may change some function; but if the neurodevelopmental foundation is not established, abnormal neural patterns and function are only going to perpetuate the underlying problems, and the results are going to be limited at best. The view held by many that children with Autism Spectrum Disorder (ASD) have only limited potential and cannot substantially overcome their issues reflects the overall misunderstanding of the problem. There is a lack of attention to the uniqueness of each individual and a general misperception that we are dealing with a specific disease, waiting for a pharmaceutical cure or single intervention or magic bullet. However autism is not polio or chickenpox; you can’t catch it. It is neurologically based, regardless of the initial cause or causes. I am sure we will ultimately see that there are many causes, and like other developmental problems, that there is neither a single cause, a single solution, nor any two children who have exactly the same issues. The disease model is leading many parents, researchers, and practitioners in the wrong direction. Those with ASD are unique individuals. Yes, there is some commonality; but each individual has their own set of issues and underlying problems and associated hierarchy of needs and should not be perceived as having a disease. Again, I believe there are many causes of ASD; but the perception of autism as a disease is counterproductive.

Those who have issues that place them within the autism spectrum are aptly identified as having a pervasive developmental disorder. “Pervasive” correctly implies a whole or inclusive developmental problem affecting most or all aspects of the child’s function. The implication of this perception is that truly successful intervention and remediation requires not only a gestalt, or global, perspective of the associated developmental issues, but also must serve as the basis for prioritizing and approaching the issues as hierarchical. As an example, some of the hierarchical foundations of language include hearing, auditory tonal processing, auditory figure-ground processing, auditory sequential processing, auditory short-term and working memory, conceptual thought, executive function, general neurological organization, knowledge/experience base and, of course, need. If we are to look at a really complex function, such as social interaction, we need to address a plethora of neurodevelopmental issues in a balanced, targeted hierarchy of neurodevelopmental pieces. Merely wanting to produce a function, or asking for a function without establishing the foundation, is grossly inadequate.

Although each child is unique, there are some neurodevelopmental issues that I believe are expressed in varying degrees in virtually every individual on the autism spectrum. Successful intervention necessitates an understanding of and attention to these fairly universal neurodevelopmental components and needs, including:

Interrelationship of Neurology and Physiology

That which impacts the child’s physical function impacts their neurological function. Most children with ASD are extremely physiologically sensitive. Diets, medications, supplements, and interventions need to be applied with a gentle scientific hand, measuring and evaluating the effects of each specific component with an understanding that generally many interrelated aspects of physiological function are involved. Aggressive intervention often interferes with efforts to trigger positive neuroplasticity, which creates additional problems. Also, as the neurological function improves, so does the physiology. The child becomes healthier and less physiologically sensitive. Intervention needs to be applied gently, with the goal of producing overall health and wellness. 

The Need to Address DSAs (Debilitating Sensory Addictions)

I coined the term “DSA” a number of years ago in appreciation of what I realized was the developmentally negative and addictive nature of what are commonly called “stims” or “stimming.” Back in the early seventies we realized that the behaviors exhibited by many autistic children were very similar to what were called “blindisms” and “deafisms” in the blind and deaf communities. These ritualistic behaviors were simply the child playing with their underdeveloped or broken sensory channels. For the child with ASD, their stims, which can involve any of their sensory channels or combinations of channels, reinforce what is wrong with that channel and trigger what is called “negative neuroplasticity.” I include “debilitating” in the term because triggering negative neuroplasticity is in fact debilitating, and it impairs normal sensory function and development. It is addictive because the brain appears to react to such stimuli as it would any other addiction. The more you do it, the more you want and need it. Some DSAs are obvious, such as rocking or flapping the hands; many more are subtle and often ignored, such as watching the same video repetitively; but all are neurologically and developmentally harmful and debilitating. Remediation and intervention should include strategies to appropriately engage and redirect the child, while working to normalize the sensory channels and eliminate the addictions.

Normalization of Sensory Function

The brain develops based on the perception of the input it receives through the sensory channels. How we hear, see, feel, taste, and smell defines our world. All neurodevelopment is based upon brain plasticity. Simply stated, this means that all perceived input and brain activity affects, develops, and reinforces the wiring of the brain. Brain function is based on patterns and associations; specific sensory input, as it is perceived, stimulates the brain and triggers neural growth/connections/networks that physically change the brain and its function, whether for the good or bad. This process is called neuroplasticity. In ASD the foundational issue in the hierarchical list of concerns and treatment is normalizing sensory dysfunction. If the brain does not correctly process sensory input (thus interfering with the typical neurodevelopment and triggering what is now being referred to as negative plasticity), typical development goes awry. In the computer world they refer to “garbage in, garbage out.” Function determines structure; how you use your brain determines how it develops. Normalization of all these sensory channels establishes the foundation upon which neurodevelopment can occur. Most children with ASD have a variety of sensory issues affecting most, if not all, sensory channels. Normalization of sensory issues involves providing the child with very specific targeted interventions, creation of a controlled sensory environment, elimination of DSAs, and creation of activities that foster sensory normalization. An hour of appropriate sensory normalization therapy can be undone with five minutes of negative sensory immersion, whether self-initiated or environmentally based.

Development of the Foundation of Language, Thought, and Global Maturity

The components of the cognitive hierarchy, including sequential processing, short-term memory, working memory, complexity of thought, receptive and expressive language, conceptual thought, long-term memory, and global neurological and developmental maturity, are critically linked. For those with ASD, the issues produced from sensory dysfunction have a negative impact on this cognitive hierarchy that is in direct proportion to the degree of sensory dysfunction. Addressing and developing this cognitive hierarchy must be a focus of successful intervention.

Correcting Imbalances Between Visualization and Conceptualization

One of the more pervasive problems with those in the autism spectrum is the difficulty in being cognitively “present,” which is a reflection of the more significant underlying problem–poor conceptual thought and typically exceptional visualization. I use the term “conceptualization” to refer to thinking in words as opposed to pictures. The vast majority of autistic children are very strong visualizers and poor conceptualizers. This imbalance exists because the typical cognitive hierarchy gets obstructed. All children begin life without the ability to process language, and thus start off as visual learners and visual thinkers, or visualizers. In typical development, language processing starts kicking in within months, and the child generally develops a good balance between visualization (thinking in pictures) and conceptualization (thinking in words). Following this normal cognitive hierarchy produces an individual who can use both skills when and as needed. Disruption of this normal progression creates individuals who are too good at visualization, who do not process words well, who do not think in words well, and who therefore cannot use words well. They tend to go off into their own worlds, reliving videos or situations over and over, creating another form of perseverative DSA. One cannot develop typical language or social skills if one cannot adequately process language, understand concepts, and communicate. Remediating this imbalance necessitates the implementation of many targeted activities. It also requires that the parents understand those things that feed the visualization and perseverative DSAs, and that they apply the necessary environmental controls and restrictions.

Education and Behavior Management

Effective and efficient education and behavioral management require a thorough understanding of the child. To educate or simply manage a child with ASD, it is imperative that you first understand the uniqueness of the child, where they are on the cognitive hierarchy, how they process information, how they think, and what they know. Then based upon this collective perspective, a totally individualized educational and behavioral management program needs to be created.

A comprehensive and coordinated treatment approach for children with autism involves educating the parents and creating specific neurodevelopmental programs for each child. These programs and treatment protocols must address health and wellness, sensory issues (visual, tactile, auditory, olfactory, and taste), processing problems (auditory and visual), lack of development of and imbalance in visualization and conceptualization, fine and gross motor function, cognitive and academic function, and speech and language, as well as behavioral and social issues.

Children with ASD, like any children, are capable of attaining their innate potential, and they deserve the opportunity to do so. Successful intervention must address the uniqueness of each individual, each of their developmental areas and issues, and must include a large amount of parent education. Working together as a team, we can significantly change the lives of individuals with autism and their families.

Reprinted by permission of The NACD Foundation, Volume 29 No. 3, 2016 ©NACD

The post Perspectives and Remediation for Those with Autism Spectrum Disorder appeared first on NACD International | The National Association for Child Development.

When I first started training with Bob back in the early to mid 1990s, I was fortunate to be able to sit through hundreds of evaluations with him. Hundreds of times I heard him ask the question, “So Johnny, what do you do for fun?” One evening over a working dinner meeting he went to great lengths to tell me how important that simple little question is in getting to understand what makes a kid “tick.” It allows us to see various obsessions or DSAs (Debilitating Sensory Additions) a child may have. It allows us to see gaps in global maturity that need to be addressed. It identifies who is at a loss of how to put their thoughts into words. It also provides a wealth of information when it comes to assisting the parent in how to guide the child’s day. In this particular article I want to address how to take a passion and use it to motivate a child in the advancement of his education.

In today’s mess that has been created by politicians pushing for grading a school based on how well they teach the kids to take a specific test at the end of the year, it has become even more important for parents to focus on motivating a child at home in order to enrich his ability to become an adult who is resourceful and knows how to obtain information. If you are homeschooling you have an opportunity to do education so much better. I am always shocked when I have parents, especially of young children, agonizing over which “curriculum” to purchase. When they ask I quickly respond, “It doesn’t really matter. It is all the same: the same degree of bad.” Why take what is working poorly in the schools and reproduce it in the home? With the exception of the high school years, which have to be looked at in more detail and individually based on the course their secondary education will take, there is much more to gain by using a child’s passion to create a rich learning environment. While I am in agreement that there are areas that a child should learn “just because,” even those will be more successful if you first turn them on to a quest for knowledge in an area of interest. I can remember one of my sons taking an interest in chemistry at a very early age. When asked why, it was evident to me. His “Poppy,” my father, was a chemistry teacher and Kenny loved his granddaddy. My dad was not a man of many words until you got him talking about either gardening or chemistry. Interestingly enough, one of my older sons gravitated towards an interest in gardening, the other in chemistry. At the age of about 12, Kenny was accelerated in both his auditory digit span and his reading comprehension, which by the way, go hand in hand. He was able to self teach from his grandfather’s teaching supplies in his “free time.” By the time he was in public school, and later in the work place, this head start really paid off for him to a much greater extent than had we progressed through Science Curriculum one year at a time.

If you are not homeschooling, then it seems you have an even bigger task to overcome. In the very little time that is left after a day of going through the motions of school and homework, it is important to take the time that is available to give them a passion for learning. In this case I strongly suggest giving as much input and assistance as needed to get homework over with ASAP so that the fun stuff can begin. I remember how Bob once told me about his son and how one of the first areas of passion in his life was basketball. Bob used the Utah Jazz to create an enjoyment in learning without him even knowing it. Together there wasn’t a stone left unturned in knowing statistics, sequencing and mental math with jersey numbers, going to games as rewards, and many other creative ways to work basketball into processing and academic advancement.

I am always shocked at some of the monotonous writing assignments given in school. The one that really pushes my buttons is when they assign the child to write a persuasive paper and give them a topic that they have no frame of reference for or don’t have any interest in. To become a good writer, it is much more productive to use a subject that the student already has a foundation of knowledge in and has a passion for. On program many of you will have “Fun Unit Studies” written on a line of your program. Truthfully, I wish we could make that one little line about 5 inches bigger than the rest of the academic activities. It seems to be an item left off more times than not and is a huge loss in opportunity. I think that most of the time it is because you really don’t grasp what we mean by “Fun Unit Study” to begin with. It is not meant to be a note to motivate you to purchase pre-packaged curriculum. How can anything be individualize and yet pre-packaged? While there are some wonderful tools that can be used for unit studies, we do not mean following a plan that is laid out without the interest of the child taken into consideration. Some of the best unit studies start with a simple question from the child. If it is fun to continue gathering information, then continue. If it loses its appeal, move on to something else. I can remember the first time one of my son’s saw a school history book. He was disgusted that Christopher Columbus got less than half of a page devoted to him. His comment was, “Didn’t we spend 6 months learning all about things to do with him?” Then he went on to list the things not covered in the history text. These were things he had learned approximately 6 years before. The reason he retained that information over the course of time was because he was interested in the first place and we proceeded in a fun way with the learning.

I want to let you observe two videos that have been sent to me by wonderfully smart boys on my caseload who inspired me to write this article. I will not go into their original challenges that brought them to us, but I will say that each of the mothers has done an amazing job of working to put pieces together so that their brilliance can shine through. These parents have an understanding of how to work on processing and make learning child-centered. As a result these boys have retained information in areas of interest that they have spent a lot of time gathering. They research their topics of interest and share with an enthusiasm that makes me want to learn more about what they are saying.

As you look towards a future for your children, let’s not bore them with meaningless memorization for tests only to have them forget most of what is drilled in to them. Let us explore their passions, research and expand knowledge, and work with them on ways to communicate to others in a way that makes the information come alive.

Reprinted by permission of The NACD Foundation, Volume 26 No. 2, 2013 ©NACD

The post Passionate Learning appeared first on NACD International | The National Association for Child Development.

When Michael and Mark were born 3 1/2 months prematurely, no one expected they would live through the day*. But they were fighters, and despite several setbacks they came home from the hospital at 3 months old, which was 3 weeks before their due date. Yet, I soon began noticing developmental delays; and when the boys were 15-months-old, they were diagnosed with Cerebral Palsy (CP). Michael, the doctors told me, would probably have learning disabilities, and Mark would fare far worse—the best that could be anticipated for him would be learning disabilities, but most likely he would be “mentally retarded,” and neither of them would ever walk.

Soon after the diagnosis, we began traditional therapy and the boys made some progress. However, despite the good intentions of those who worked with my children, I could tell that only the symptoms of CP were being treated, not the brain injury itself. As a nurse, I knew that if my little boys were to have a chance at a normal life, the root of the problem needed to be addressed. The NACD did exactly that.

The boys were three years old when we began the NACD program. Deficits in sensory abilities are common in CP, and our boys were no exception. Neither one could feel things normally—they had limited feeling in some areas and hypersensitivity in others. They were also hypersensitive to sound, and loud noise and music caused them a great discomfort; they would cover their ears and cringe. So their individualized programs included targeted neurodevelopmental and sensory-motor activities which helped stimulate the development of new neural pathways.

Initially, the boys’ sensory dysfunction was such that they had difficulty tolerating some of the activities; but with time they adjusted to the various forms of tactile stimulation and later even began asking for it. Eventually, Mark and Michael acquired a much more normal awareness and feeling. An example of this development is the “case of the eyelash.” One day I noticed an eyelash in Mark’s eye. It was black against white, but his eye never registered it as a foreign object. Then, several years later, Mark came in from outside rubbing his eye, his eye all red, asking me to get this “thing” out of his eye. I never did find the “thing,” as I’m sure he flushed it out with tears, but I was thrilled! His brain was finally properly processing foreign objects in his eyes.

The doctors and therapists had told us that the boys would never walk and wanted them to use wheelchairs; but knowing that unused muscles atrophy, we refused the wheelchairs and worked on preparing their brains for walking. Mark was already crawling when we saw Bob, but Michael wasn’t. We began teaching the boys to crawl in a serialized pattern, and later did cross patterned walk, over and over again, with an overhead ladder. When Mark took his first independent steps across the room, I screamed with joy so loudly that I scared him!

I am the first to say that this has not been an easy road. We worked on the NACD program with Michael and Mark and home-schooled all four of our boys. John was a year older and Tim was four years younger. Although our friends and relatives were generally supportive, some urged us to put the children in public school in order to get free therapy so that I wouldn’t have to work so hard. When the boys were in third grade we did just that for the purpose of me “getting a break.” I quickly realized that our goals for the boys were different than the school’s. For example, the goal of Michael’s physical therapy at the school was for him to get in and out of the wheelchair and safely maneuver through doors, not to build him up to walk. We ended up pulling the boys out of school within two months because the experience was so negative. Yet, it was an invaluable training for me. I witnessed firsthand that just because something is free does not mean that it is good. Truth was I could do more brain changing and capacity building at home in one day than the school could do in more than a week. I also saw that the school’s philosophy was to create an environment in which my children could function; but the NACD offered to change my boys and teach them how to function in any environment.

And the boys changed. Even though they had identical diagnoses, their NACD programs were very distinct and highly individualized. Each program piece—processing, academic, and physical—worked together toward increased brain capacity. At times Mark and Michael made huge progress in short periods, and other times they seemed to make no improvement at all. But as we persevered over the years we continued to see constant growth and significant brain change that went above and beyond what anyone ever expected. Now, at 23, they are accomplishing amazing things.

At home Michael can now walk independently, but still needs a walker outside of the house. He is finishing the requirements for a high school diploma through an online program and is earning excellent grades in his classes while doing all work entirely on his own, except for some tutoring in math and typing in English.
Mark has been walking without assistance since he was seven. He obtained his GED and then graduated from a local technical school with a certificate in Digital Audio Production and earned a 4.0. Currently, he is finishing an associate’s degree in general studies at Valencia College and in the fall will be transferring to the University of Central Florida to complete a bachelor’s degree. The only accommodation Mark has in college is that he is given an extra half hour during tests because it takes him longer to write his answers, and he sits in the front of the class. Even though as an infant he was diagnosed with Retinopathy of Prematurity and was considered legally blind in one eye, his vision has continued to improve throughout his life on program, and he now reads and functions very well. Mark comments that his NACD visual activities have paid off and that his vision is still improving.

Both young men are incredibly independent, and thanks to their years of NACD cognitive activities, they can reason through complex problems and situations. Their high processing abilities (Michael’s auditory digit span is 10-11 and Mark’s is 11-12) have even helped overcome some of their physical weaknesses—it is easier to remember a lecture, for example, than to take notes in class. Michael and Mark also have goals for the future which include living on their own and having careers. Several years ago, they had a taste of living without mom and dad. Because they can cook and clean and have been doing their own laundry since they were twelve, spending six weeks alone at home wasn’t a problem. Mark is training to be a sports broadcaster, and Michael wants to design video games without violence, sexual content, and objectionable language.

Working with the NACD has definitely been a great choice for our family. The NACD has empowered us as parents with skills, knowledge, and resources to help Michael and Mark achieve far more than what was expected of them because of their diagnosis. Our experience with the NACD has not only assisted us with our sons, but with our international missionary work as well. We have been able to use NACD’s processing activities and Simply Smarter program to help children and adults all over the world. We thank our Lord Jesus for Bob and his team for the major part they have played in our lives!

*For a detailed account of the beginning of our NACD journey, please click here.

Reprinted by permission of The NACD Foundation, Volume 26 No. 2, 2013 ©NACD

The post Twenty Years Later appeared first on NACD International | The National Association for Child Development.

The following story about Ross exemplifies the potential strengths of children who have been labeled as being within the spectrum and also the potential danger of labeling and classifying individuals.

https://youtu.be/sOiodNTCJS8

I proudly identify many of my good friends as “nerds,” a classification that I have often wished to be able to share, regardless of the fact that if they were children today they would have been labeled as being with the Autism Spectrum. I, however, have had to settle for the strengths that I have relative to more plebian labels such as Dyslexic or Learning Disabled. I haven’t been able to reach the heights of many of the “nerds” because my sensory functions are nothing extraordinary nor am I blessed with exceptional visualization skills, as are so many of the individuals labeled as being on the “spectrum.” So I have had to take advantage of some of my strengths, such as those that permit me to view issues with a gestalt and creative perspective.

I have often professed that our strength as a species lies in our uniqueness as individuals–differences that need to be identified, acknowledged, sometimes controlled or treated, but also developed and often celebrated. For those within the “spectrum,” most of the world does not realize that often the debilitating sensory addictions and excessive visualization issues that can produce such devastating development issues, when brought under control, can and are, in fact, gifts and strengths.

It is a tragedy that so many unique and exceptional individuals are labeled and never really given an opportunity. Yet if they are perceived as truly unique individuals with challenges and gifts, not labels, and given the opportunity to bring their exceptionalities under control and to learn to use their strengths and gifts, they can in fact be incredible contributors to our planet and live happy, successful, productive lives.

Vive la difference!

Lyn Waldeck

As an Evaluator with NACD, there are certain days that just stand out as being excellent. Today was one of those for me. NACD has been working with the Williams family for about 10 years now. As Ross was originally diagnosed in the Autistic Spectrum, consistency on program has paid off for this hard-working and diligent family. One step at a time and over several years, he continues to step away from the limitations of his diagnosis and leave symptom by symptom behind. Today Ross is a focused, determined, well-rounded teenager. He enjoys basketball, makes good grades in regular classes at a high-performing school in Houston, Texas and has wonderful social skills.

https://youtu.be/zqZU-PwfYLw

About 18 months ago, he showed an interest in playing the piano and his parents started him in lessons. At his recent evaluation he brought his portable keyboard to show his evaluator what he has been working on. We share this with you now as an encouragement to never give up in helping your children to achieve their full potential as they explore life, seeking their passions and enriching their future.

NACD Newsletter, Volume 5 Issue 2, 2012 ©NACD

The post A New View of Children within the Autism Spectrum – Ross appeared first on NACD International | The National Association for Child Development.

National Association for Child Development

One of the areas of parental concern for the development of any baby is the area of mobility. Watching a baby learn to crawl, creep, stand and walk are thrilling to all parents. As a parent we can see our child learn to better explore their world and move from dependence to independence sometimes in the time span of the first year.

As a parent of a DS child, you may have a special concern about your child’s development of mobility. Cardiac conditions can slow down the emergence and development of mobility. The potential or reality of low muscle tone and poor tactility can also slow down development in this area drastically. Parents are often tempted to skip mobility developmental stages in an effort to reach the coveted skill of walking more rapidly. The consequences of this strategy can be very long lasting and impact other developmental areas as well.

Why stomach crawl? Crawling on your stomach on the floor in a cross pattern is hard work. Aside from people training in the military, few of us have spent any time past our first year of life utilizing this movement. What is to be gained by doing it, and why does your baby need this essential first form of locomotion? There are several reasons. Your child’s eyes begin the work of learning to focus and converge together on near-point objects, a skill which is needed for everything from reading to depth perception. The tactile feedback given by the entire body moving against the friction of the floor teaches your child the location of the entire torso, arms and legs, and feet and hands. Proprioception, knowing where your body is in space, is based on these early messages of tactile input on the floor and feeling every movement through the feedback of this contact. The child is learning that they have two legs, two arms, two feet and two hands because they can feel these parts moving against the floor. Crawling engages virtually all of the muscles of the body, from the arches of your feet to your abdominal and neck muscles, all of which are used in the process of moving your body forward across the floor. Arm, chest and back muscles are utilized in pulling the arms forward and then pulling the body forward. Quads, hips and hamstrings are worked during the leg movement. This is a workout!

Learning coordinated movement starts here with crawling on the floor. Whether the child picks up the cross pattern movement on their own or they learn it through parent assistance, this is the beginning of that very fundamental movement of a right arm and left leg, left arm and right leg– the movement we use to walk and run, climb stairs and climb hills. When the child learns this by working on the belly crawl, they get all of that helpful tactile information through the limbs and through the torso, laying a strong foundation for more advanced forms of mobility. They also develop a very critical physical piece through crawling– muscle balance. The crawling movement is one of flexion and extension of the arms and legs, pushing and pulling using the flexor muscles, then the extensor muscles. One of the issues confronting many parents of children with Down Syndrome is that they are often advised that the child needs to begin developing trunk strength and tone through sitting because it is this lack of trunk strength and tone that creates the problem with crawling and walking. If sitting were the best thing for the development of the trunk, every adult would have strong backs and great abs. Sitting is not what develops the trunk; crawling and creeping is. The child should not sit independently until they can get themselves into that position independently, which is typically after they have learned to crawl on their tummy and creep on their hands and knees.

Another very significant aspect of crawling involves the integration of sensory input. Crawling provides the brain with what is quite possibly the best integrated sensory input that a child ever receives. This act of crawling sends simultaneous information to the brain from all of the tactile and proprioceptive receptors, the surface receptors, the deep receptors and the proprioceptive receptors in the joints. And not only is the brain receiving all of this input, it is receiving it through the simultaneous input from the movement of the right arm and left leg, and the left arm and right leg. This is very powerful sensory-integrating input. Many children, when they start to move forward on the belly, have to learn where their pieces are before they can really start coordinating their movement. Many start by just pulling with both arms together or both legs together. These children are learning where their arm and legs are. Then with a little time and help they begin to alternate arms or legs, and sometimes they get the arm and leg moving on one side of the body, or leave out one leg. As children go through these phases, they are getting more and more input, developing tactility, strength, tone, muscle balance, vestibular balance function, and proprioception. Furthermore the brain is learning to integrate all of this critical information. Given some time and some help, their brains and bodies can learn all of these critical developmental pieces and establish the foundation they need for all future physical and neurological function. It is also important to note that those children who find it the hardest to crawl need it the most, for they are the ones who really need to put all these pieces together properly.

Some children move through this stage very quickly and move on to creeping on hands and knees. Some children take longer to learn this stage and may need a great deal of extra input to locate their limbs in order to be able to control those movements. This may take longer than parents expect, but is time well spent. Children moving from a good cross belly crawl to a good cross pattern creep on hands and knees are in good shape to move on to developing proper walking. Children moving from rolling to scooting to sitting to walking have not had the opportunity to learn where they are in space and how to move their limbs in an organized fashion, nor have they developed the proper muscle balance or strength. They potentially have not even learned how to focus on close objects or to use their eyes together for depth perception.

Short cuts and quick fixes will lead to later repercussions. Don’t take the chance. Try to do it correctly the first time and avoid thousands of hours of time in the future in physical and occupational therapy trying to overcome the problems that are often created by skipping this critical developmental activity.

Reprinted by permission of The NACD Foundation, Volume 22 No. 12, 2009 ©NACD

The post Down Syndrome: The Importance of Crawling on the Stomach appeared first on NACD International | The National Association for Child Development.

Printed in the Autism
Health and Wellness Magazine
Volume 1 Issue 3 – Autumn 2009

Bob Doman has been working with autism since the late 1960’s and was part of the team that first discovered the connection between sensory dysfunction and autism. Bob has been instrumental in establishing the foundation for today’s understanding of neurodevelopment and those within the autism spectrum.

Understanding and remediating neurodevelopmental issues of those within the autism spectrum is critical if we are going to provide these individuals with an opportunity to overcome their debilitating developmental issues and to function within “typical” or “normal” limits. The underlying neurodevelopmental issues associated with autism are often not addressed. And when they are addressed, it is often only in part or with inadequate or inappropriate interventions. A thorough understanding of all of the related pieces is necessary if a comprehensive and effective strategy is to be created and implemented.

Most neurodevelopmental issues will not simply go away. Teaching new skills or utilizing aggressive medical or nutritional intervention without addressing the underlying issues may change some function; but if the neurodevelopmental foundation is not established, results are going to be limited at best. And sadly, some of the more aggressive treatments may actually be harmful and cause regression. The predominant view that most children within the spectrum have only limited potential and cannot overcome their issues reflects the overall misunderstanding of the problem. There is a lack of attention to the uniqueness of each individual and a general misperception that we are dealing with a specific disease that will ultimately be cured or eradicated through pharmaceutical or medical intervention. Autism is not polio or chickenpox; you can’t catch it. It is neurologically based, regardless of the initial cause. I am sure we will ultimately see that there are many causes, and like other developmental problems, that there is neither a single cause nor a single solution. The disease model is leading many parents, researchers, and practitioners in the wrong direction. Those within the spectrum are unique individuals, each with their own set of issues and underlying problems, who should not be perceived as having a disease. Those who are and were within the spectrum cover a broad range of ability and disability. Included within the autism spectrum are those who have been “cured,” who are no longer identifiable as having a problem, to savants such as “The Rainman,” Kim Peek, or Daniel Tammet, to those individuals who are so involved and dysfunctional that they cannot be safely maintained in anything other than a very protected, restrictive, and controlled environment.

Discovering, understanding, and learning how to address the unique underlying neurodevelopmental issues has been an effort of a lifetime and a dynamic process. Each insight opens more doors, assists in the understanding of these unique minds, and leads to better results.

Although each child is unique, we have discovered some neurodevelopmental issues that are expressed in varying degrees in virtually every individual on the spectrum. Successful intervention necessitates an understanding of and attention to these fairly universal neurodevelopmental components, including:

Neurology and physiology are interrelated. That which is impacting the child’s physical function impacts their neurological function. Most children on the spectrum are extremely physiologically sensitive. Diets, medications, supplements, and interventions need to be applied with a gentle scientific hand, measuring and evaluating the effects of each specific component with an understanding that generally many interrelated aspects of physiological function are involved. Aggressive intervention often creates another problem. Also, as the neurological function and efficiency improves, so does the physiology–the child becomes healthier and less physiologically sensitive. Intervention needs to by applied gently, with the goal of producing overall health and wellness.

The brain develops if it receives specific, appropriate input through the sensory channels. Specific auditory, visual, and tactile input stimulates the brain and triggers neuro-growth that physically changes the brain and its function. This process is called neuroplasticity. In autism the primary issue is sensory dysfunction. The brain does not correctly process sensory input, thus interfering with the typical neurodevelopment and triggering what is now being referred to as negative plasticity. Function determines structure; how you use your brain determines how it develops. Normalization of all these sensory channels establishes the foundation upon which typical neurodevelopment can occur.

Abnormal sensory function coupled with low sequential processing generally leads to what I have coined as DSAs—Debilitating Sensory Addictions. Generally DSAs are referred to as “stims,” or self-stimulatory behaviors. The reality of DSAs is that the child is playing with what is improperly developed or “broken” in a sensory channel. For example, under-developed central vision and enhanced peripheral vision trigger DSAs that involve the child fixating on the movement or edges of objects. This behavior becomes additive, with the brain responding exactly as it does to a drug or any other addiction. It thus results in the creation of a more addictive brain, which further delays the development of the central vision, the component of our vision primarily responsible for learning, and focuses the brain on fulfilling the addiction. These DSAs often involve many, if not all, sensory channels; and they often dramatically disrupt and corrupt typical development.

Complexity of thought, conceptual thought, language, and global neurological and developmental maturity are critically linked. For those within the spectrum, the developmental delay produced from the sensory dysfunction creates both neurodevelopmental delay and an imbalance affecting these critical functions. The delay is in the development of sequential processing. Sequential processing is the ability to take in a series or sequence of auditory or visual information and to then hold those pieces together and manipulate them. This ability is that which permits us to learn and think. The primary global neurodevelopmental difference between a typical child of one, two, three, four, or five years of age is the difference between their abilities to process information sequentially. Delaying the development of sequential processing delays critical aspects of the child’s total development. Delays in auditory and language development create an imbalance between the ability to think in pictures (i.e. visualization–typically very strong in those with autism) and the ability to think in words (i.e. conceptualization–generally significantly delayed in this population). This imbalance, if not addressed, can and often does have a devastating effect on the ability to process, understand, and utilize language, as well as the ability to think conceptually, thus impacting global function.

A comprehensive treatment regime for children with autism and those on the spectrum involves creating specific neurodevelopmental programs for each child. These programs and treatment protocols must address health and wellness, sensory issues (visual, tactile, auditory, olfactory and taste), processing problems (auditory and visual), lack of development of and imbalance in visualization and conceptualization, fine and gross motor function, cognitive and academic function, and speech and language, as well as behavioral and social issues. We tackle these issues by designing a very child-specific, holistic, coordinated Targeted Developmental Intervention (TDI)® program. A TDI program is created after we thoroughly review the child’s history and conduct an in-depth developmental and educational assessment.

The work we do at NACD with children with autism has changed the previous notions that they are unable to progress and learn, or that the only effective treatments are behavior modification programs and skill-based training programs. NACD does not see children on the autism spectrum as being unreachable. We respect them for who they are and believe that they, like any child, are capable of attaining their innate potential and that they deserve the opportunity to do so.

Reprinted by permission of The NACD Foundation, Volume 22 No. 10, 2009 ©NACD

The post Neurodevelopmental Perspectives on Autism and Asperger’s Syndrome appeared first on NACD International | The National Association for Child Development.